Disease activity and severity in postmenopausal rheumatoid arthritis patients

Atwa, Essam; Omar, Hesham; Elanwer, Asmaa; Hammad, Marwa

doi:10.21608/zumj.2020.26616.1785

Disease activity and severity in postmenopausal rheumatoid arthritis patients

Document Type : Original Article

Authors

¹ Rheumatology and Rehabilitation department,Faculty of medicine, Zagazig University, Sharkia, Egypt

² Clinical Pathology department, Faculty of medicine, Zagazig university, Sharkia, Egypt

³ Rheumatology and Rehabiltation department, El Helal specialized hospital, Egypt

⁴ Rheumatology and Rehabilitation Faculty of medicine, Zagazig University, sharkia, Egypt

10.21608/zumj.2020.26616.1785

Abstract

Introduction: The fact that the incidence of RA in women reaches its peak during menopause (45-55), highly recommends a strong estrogenic role in disease etiology. Although in some studies postmenopausal women who experienced RA had less joint scores than pre-menopausal patients, the post-menopausal period has been associated with increased disease activity and more severe functional disability.
Aim: The aim of this study was to evaluate the relation of serum estrogen and follicular stimulating hormone in menopause and disease activity and severity in postmenopausal RA patients.
Methods: This is a cross-sectional study that was carried out in Rheumatology and Rehabilitation deparment, Faculty of Medicine, Zagazig University Hospitals on 84 postmenopausal RA patients. Disease activity was assessed using Disease Activity Score 28 (DAS 28). Severity of RA was assessed by the RA severity scale (RASS). Laboratory parameters were recorded including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP). Estrogen (E2) and follicular stimulating hormone (FSH) were measured for all patients.
Results: Our study showed a statistically significant difference between serum estrogen (E2) levels among different stratifications of DAS28 in postmenopausal RA patients. Moreover, there was a significant positive correlation between E2 levels and disease severity RASS score. FSH levels showed no significant correlations with disease parameters.
Conclusion: Although it is well known that menopausal women have very low levels of E2 compared to women of reproductive age, in postmenopausal RA patients, higher disease activity and severity was associated with higher levels of estrogen denoting its prominent pro-inflammatory effect even in the postmenopausal period.

Keywords